A US randomized, 4-period crossover feeding study revealed that sodium reduction, especially when combined with a Dietary Approaches to Stop Hypertension (DASH)-style diet optimized for diabetes (DASH4D), can significantly lower blood pressure (BP) in patients with type 2 diabetes (T2D) and high BP, even among those already using multiple antihypertensive medications. From June 2021 to June 2024, there were 102 participants (85 completed all diet periods; average age 66, 66% women, and 87% Black) with T2D, systolic BP of 120–159 mm Hg, and diastolic BP under 100 mm Hg. The DASH4D diet was a modified DASH-style plan tailored for T2D patients, featuring lower carbohydrates, higher unsaturated fats, and reduced potassium compared to the original DASH diet. Participants, who were provided with all meals and maintained constant weight, followed four five-week diet periods: (1) DASH4D with lower sodium (a limit of 1,500 mg per day), (2) DASH4D with higher sodium, (3) a typical U.S. diet with lower sodium, and (4) a typical diet with higher sodium (reference). Compared with the typical high-sodium diet, the DASH4D diet with lower sodium reduced systolic BP by 4.6 mm Hg and diastolic BP by 2.3 mm Hg, with most reductions occurring within the first three weeks of each diet period. Sodium reduction had a stronger effect than the diet pattern itself, and adverse events were rare. These findings suggest that sodium reduction combined with a DASH-style diet have clinically meaningful beneficial effects. The original DASH diet is rich in fruits, vegetables, and low-fat dairy products, and low in saturated fat and cholesterol. People with T2D and high BP face a high risk of cardiovascular events related to elevated BP. Source: https://jamanetwork.com/
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